Azarnia Somaye, Ezzati Kamran, Saberi Alia, Naghdi Soofia, Abdollahi Iraj, Jaberzadeh Shapour
Department of Physiotherapy, Iranian Research Centre on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13834, Iran.
Neuroscience Research Centre, Poorsina Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht 41937-13111, Iran.
Brain Sci. 2023 Jul 20;13(7):1100. doi: 10.3390/brainsci13071100.
Uni-hemispheric concurrent dual-site anodal transcranial direct current stimulation (UHCDS a-tDCS) of the primary motor cortex (M) and the dorsolateral prefrontal cortex (DLPFC) may enhance the efficacy of a-tDCS after stroke. However, the cellular and molecular mechanisms underlying its beneficial effects have not been defined. We aimed to investigate the effect of a-tDCS on brain metabolite concentrations (N-acetyl aspartate (NAA), choline (Cho)) in stroke patients using magnetic resonance spectroscopy (MRS). In this double-blind, sham-controlled, randomized clinical trial (RCT), 18 patients with a first chronic stroke in the territory of the middle cerebral artery trunk were recruited. Patients were allocated to one of the following two groups: (1) Experimental 1, who received five consecutive sessions of a-tDCS M (active)-DLPFC (active). (2) Experimental 2, who received five consecutive sessions of a-tDCS M1 (active)-DLPFC (sham). MRS assessments were performed before and 24 h after the last intervention. Results showed that after five sessions of a-tDCS there were no significant changes in NAA and Cho levels between groups (Cohen's d = 1.4, Cohen's d = 0.93). Thus, dual site a-tDCS did not affect brain metabolites compared to single site a-tDCS M.
对初级运动皮层（M）和背外侧前额叶皮层（DLPFC）进行单半球同步双部位阳极经颅直流电刺激（UHCDS a-tDCS）可能会提高中风后a-tDCS的疗效。然而，其有益效果背后的细胞和分子机制尚未明确。我们旨在使用磁共振波谱（MRS）研究a-tDCS对中风患者脑代谢物浓度（N-乙酰天门冬氨酸（NAA）、胆碱（Cho））的影响。在这项双盲、假刺激对照、随机临床试验（RCT）中，招募了18名首次发生大脑中动脉主干区域慢性中风的患者。患者被分配到以下两组之一：（1）实验组1，接受连续五节a-tDCS M（有效）-DLPFC（有效）治疗。（2）实验组2，接受连续五节a-tDCS M1（有效）-DLPFC（假刺激）治疗。在最后一次干预前和干预后24小时进行MRS评估。结果显示，五节a-tDCS治疗后，两组之间的NAA和Cho水平无显著变化（科恩d值=1.4，科恩d值=0.93）。因此，与单部位a-tDCS M相比，双部位a-tDCS不影响脑代谢物。
